Organization Name: | PC COUNSELING SERVICES, LLC |
NPI Number: | 1104224625 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANITA WILEY (LICENSED CLINICAL PROF COUNSELOR) |
Mailing Address: | 11680 Doolittle Dr Suite 116 Waldorf |
State: | MD US |
Postal Code: | 206023801 |
Phone Number: | 3016539587 |
Fax Number: | |
NPI Enumeration Date: | 12/16/2014 |
NPI Last Update Date: | 05/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LC5129 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |